Validation of the postoperative Quality of Recovery-15 questionnaire after emergency surgery and association with quality of life at three months

PURPOSE

The Quality of Recovery-15 (QoR-15) tool, validated for measuring postoperative recovery following scheduled surgeries, has not been psychometrically assessed in emergency contexts. Moreover, the QoR-15's associations with long-term outcomes remain underexplored. This study aimed to confirm the validity and reliability of the QoR-15 following emergency surgery and assess its association with three-month postoperative quality of life.

METHODS

We conducted a prospective cohort study (August 2021-April 2022) on adult patients who underwent emergency surgery. The QoR-15 questionnaire was administered before surgery (H0) and at 24 hr (H24) and 48 hr (H48) after surgery. We examined the H24 score's associations with both the three-month quality of life, as assessed by the EQ-5D scale, and the number of days spent at home at 30 (DAH30) and 90 (DAH90) days.

RESULTS

Of the 375 included patients, 352 (94%) completed the QoR-15 at H24 and 338 (90%) were followed up at three months. The population represented the following diverse surgical specialties: orthopedic (51%), gastrointestinal (27%), urologic (13%), and others (9%). The QoR-15 questionnaire confirmed all psychometric qualities (internal consistency, reproducibility, responsiveness, acceptability, construct, and convergent validities) in the emergency context. The average minimum clinical difference was 8.0 at H24. There was an association between QoR-15 at H24 and the three-month quality of life (r = 0.24; 95% confidence interval [CI], 0.14 to 0.34; P < 0.001), DAH30 (r = 0.33; 95% CI, 0.23 to 0.41; P < 0.001), and DAH90 (r = 0.31; 95% CI, 0.22 to 0.40; P < 0.001).

CONCLUSION

The QoR-15 score is valid for measuring early postoperative recovery after emergency surgery. The H24 score significantly correlated with both the three-month quality of life and the number of days at home.

STUDY REGISTRATION

ClinicalTrials.gov (NCT04845763); first submitted 11 April 2021.

Impact of the presence of a humanoid robot in the anesthesia visit waiting room on patient's satisfaction. The PEPPER before-after study

BACKGROUND

The quality of information during a medical visit, such as a preoperative anesthesia visit, impacts patient's satisfaction. New digital supports, including humanoid robots, have been recently proposed to provide medical information to patients. We aimed to assess whether the presence of a PEPPER humanoid robot, programmed to deliver information about anesthesia and surgery and placed in the waiting room for a preoperative anesthesia visit, can improve patient overall satisfaction.

METHODS

We conducted a prospective, observational, before-after study. French-speaking adult patient global satisfaction (rated from 0 to 10) was measured after a scheduled preoperative anesthesia visit (for orthopedic, abdominal, urologic surgeries or for endoscopy), by direct interview with a research person, before modification of usual practices (information leaflets and brochure were given to the patients prior to the visit), and after the implementation in the waiting room of a PEPPER humanoid robot programmed to deliver information about anesthesia and surgery through short videos, designed by a group of healthcare workers and patients.

RESULTS

Two hundred ninety-six patients (237 [80%] ASA I-II) were included, 179 before and 117 after periods. Patient global satisfaction was not different (8.9±1.6 vs. 9.0±1.4/10, for before and after periods, P=0.53). However, the satisfaction on the information about risks was significantly improved in the after period (8.5±2.3 vs. 9.1±1.4/10, P=0.017).

CONCLUSIONS

The presence of a humanoid PEPPER robot in the waiting room did not improve patient's global satisfaction about anesthesia visit.